RVH 2012/2013 Annual Report

BUDGET We are pleased to report that we have achieved a balanced budget for the 23rd consecutive year for the period ending March 31st, 2013. Hospitals will receive no funding increase for 2013/14 and should not anticipate increases in the near future.

DIALYSIS RVH received approval for a $10 million expansion of our hemodialysis unit in 2011. Over the next few years RVH will undergo the largest transformation in its history. Through major construction of a new nephrology centre and renovation to the existing infrastructure, a modern, patient-centered facility will be built. This summer we will start with Phase 1 which is the demolition of houses, expanded parking, electrical, draining and a gated parking system. The two storey addition at the back of the hospital will see a state-of-the-art nephrology centre housing 20 hemodialysis stations, peritoneal dialysis, and renal insufficiency clinics. Post construction areas that will be impacted will be Oncology, Pharmacy, Ambulatory Care, and the 2nd and 3rd floors.

This is a complex project which represents the largest investment the MOHLTC has ever made at RVH. We continue to work with the Ministry, our architects and engineers through the five stages of the MOHLTC capital planning process with an estimated completion date of February 2015.

PROJECT PHASES

We are proud of the growth and progress of Renfrew Victoria Hospital and we are excited to begin this new period of development to ensure we remain a strong community hospital.

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ANNUAL REPORT 2012-2013

PHASE 1 EARLY WORKS

Demolition of houses Expanded parking - electrical,

drainage, gated parking lot system, etc.

PHASE 2 NEW CONSTRUCTION

Nephrology unit and shelled space 20 treatment stations Nephrology clinics Diabetes Education Program Chronic disease education and

management clinics

PHASE 3 FIT-UP

Development of shelled spaces: o Pharmacy o Physician’s Sleep Room

Improved space on in-patient units.

SERVING THE COMMUNITY FOR 116 YEARS

RVH 2012/2013 Annual Report

HEALTH LINKS The Champlain LHIN has organized health link areas and ours is called “The South Renfrew Health Link” and includes the Highway 60 corridor (including the Town of Renfrew and Calabogie) extending to Barry’s Bay (including Whitney /Madawaska), Golden Lake and Quadeville. The lead organizations are St. Francis Memorial Hospital, Rainbow Valley CHC and Renfrew Victoria Hospital with many collaborating partners i.e. Paramedic Services, Groves Park Lodge, Addiction Treatment Services, etc. Health Links will encourage greater collaboration between existing local health care providers, including family care providers, specialists, hospitals, long-term care, home care and other community supports. With improved coordination and information sharing, patients will receive faster care, will spend less time waiting for services and will be supported by a team of health care providers at all levels of the health care system.

QUALITY IMPROVEMENT PLAN (QIP) This plan is a component of the Excellent Care For All Act, 2010 (ECFAA). The QIP outlines the organization's priorities for quality improvement and articulates a strategy for implementation. Every year this is posted on the hospital website as well as the progress made from the previous year.

The medical staff are commended for maintaining staffing, services and high quality of care in our community.

We continue to recruit new physicians, and mentor residents and medical students in order to meet the needs of the hospital medical staff.

In August 2013, Dr. Angela Varrin will be joining the Renfrew Medical Group and in October 2012, Dr. Daniel Duggan signed with Renfrew and Area Health Services Village with a start date in 2014.

This past year we had 28 medical students/ residents for 553 days in all areas of the hospital and in physician practices compared to 23 medical students/ residents working for 415 days last year. Most students/residents came from the University of Ottawa, and Queen’s University. All medical trainees are under the direct supervision of a physician.

The medical staff has been engaged in continuing professional development through educational sessions at the beginning of each medical staff meeting as well as attending a variety of courses/sessions that support their ongoing learning. Morbidity and Mortality rounds are being developed for quality improvement.

In March 2013, physicians completed a comprehensive Rural Trauma Team Development Course taught by the physicians and emergency nursing staff at the Regional Trauma Centre, Ottawa Hospital, focusing on trauma in a rural centre. RVH also hosted a regional Advanced Trauma Life Support Course and will be hosting a Pediatric Trauma day in early June 2013. RVH also provides Advanced Cardiac Life Support update course twice each year.

A complete range of healthcare services are available through our linkages with the Ontario Telemedicine Network (OTN). This service has grown to 57 consultants with various services compared to 24 consultants in 17 specialties in 2011. This provides access to consultants closer to home.

All of the usual clinical services including hospital emergency room coverage, inpatient care, complex continuing care, obstetrics, dialysis, diagnostic services, etc. have continued to be provided throughout the year.

Our medical staff continues to support the delivery of medical services closer to home, and will continue to be innovative partners as we work closely with The Ottawa Hospital, The Ottawa Heart Institute and the new Health Links initiative.

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RVH 2012/2013 Annual Report

RVH 2012/2013 Annual Report

Our Mission: The Renfrew Victoria Hospital is a values-driven organization dedicated to excellence in health care.

Our Values: Quality We strive for excellence in both the delivery of safe and high quality patient care services and the establishment of a healthy and safe work environment. Dignity & Respect We respect the individual rights, dignity and values of patients and those caring for and supporting them. Patient Focus We believe patients should be active participants in their care, which is best achieved through an inter-disciplinary team who addresses the physical, psychological, emotional and spiritual needs of the patient.

Patient Safety We promote an environment that encourages exploration, exposure and resolution of patient safety issues. We strive to achieve measurable improvements. Leadership We foster a culture that encourages everyone to embrace ownership, innovation and advocacy. Responsiveness & Adaptability We endeavour to be responsive to the needs of the individual and the community and to factors in the external environment.

Our Vision: The Renfrew Victoria Hospital will be recognized as one of the finest rural health care facilities that endeavours to improve the health status of the population, in a fiscally responsible manner, by mobilizing technology, responding to identified needs and partnering with others.

RVH 2012/2013 Annual Report

FINANCIAL PERFORMANCE (EFFECTIVENESS) QUALITY OF CARE (SAFETY/PATIENT-CENTERED)

Capital Expenditures $1,694,606 Operating Budget $38,700,000

o Operation Surplus $1,310,000 Total Number of Patient Days 18,069

o Direct cost per Patient Day $348.00 Average Resource Intensity Weight 1.7 Paid Hours 497,645 Total Worked Hours

o Total Hospital 445,331 o Management and Support Areas 150,969 o Patient Care Workload Hours 294,362

Funding Announcements: o New Base Funding (Volume expander) $1,100

o One-Time Funding (includes Late Career

Nursing Initiative, Wait Time Strategy, Critical Care Nursing, Wait Times, MORE OB) $285,955

o Capital (Transformation Fund – Electronic Medical Record) $344,000

Tuition Assistance Program provided $40,902 to 106 employees Cost of Sick Days = $225,897 (**This does not include

replacement costs) Harmonized Dialyzer Contract with The Ottawa Hospital - annual

cost savings of $60,000 Sleep Studies revenue generated $527,570

Sleep Products revenue generated $465,588

164 Employees received influenza vaccine NRC Picker Survey for Active Care indicates that 87.5% of patients

would recommend RVH Continuous Quality Improvement project for Active Care resulted in

development of Patient Discharge Booklet Started process of migrating from Carestream to McKesson PACs – live

date of June 15, 2013 Emergency Department held a very successful Rural Trauma Education

Day (17 RN’s, 6 Paramedics, 1 Respiratory Therapist and 2 Physicians attended)

For quality and review purposes, The Ottawa Hospital provides written feedback on all trauma patients transferred from RVH

Hand Hygiene Average: 71.25% Construction to begin on Second Floor to add hand hygiene sinks and

additional washrooms to all patient rooms The Braden Scale for Pressure Ulcer Risk Assessment is completed and

documented for all Complex Continuing Care admissions Participated in the 2013 International Pressure Ulcer Prevalence Survey Created an Antimicrobial Stewardship Committee and implemented

changes aimed at patient safety Changed from addressographs to bar-coded stickers for patient identifiers Development of RNAO Best Practice Guidelines for Delirium Sustainability of RNAO Best Practice Guidelines for Pain Management Speech and Language Office was moved to a new location that is much

more convenient for out-patients and better for infection control issues Staff Safety Education days and Nursing Skills Fair Days focused on

ROPs for accreditation including medication reconciliation and two client identifiers

Automated TV screens in key areas of hospital allowing for patient and staff education related to safety

Increased to 9 Peritoneal Dialysis patients on home therapy

RENFREW VICTORIA HOSPITAL BALANCED SCORECARD 2012/2013

RVH 2012/2013 Annual Report

SYSTEM INTEGRATION (ACCESS TO CARE & INTEGRATION)

STRENGTH IN PEOPLE (WORKLIFE)

2012/13 2011/12 Average Length of Stay 12.6 13.9 % of Occupancy (Medical/Surgical) 122.9 112.48 Number of Admissions 1,218 1,238 Patient Days 18,069 16,937 Number of Babies Delivered 58 85 Number of Emergency/Outpatient Visits 29,930 31,696 Number of Clinic Visits 14,322 13,446 Number of Falls 124 138 Number of ALC Days until Discharge 5,468 6,001 Chemotherapy Visits 719 650 Hemodialysis Treatments 16,331 16,203 C-Sections Performed 7 11 Pre-Operative Visits 192 183

Total Inpatient Attendances for Physiotherapy 5,907 Regional Assault Care Program provided services to 181 clients;

927 follow-up calls and 269 follow-up visits. 18 clients on Assisted Living Program with 11 on waiting list 27% increase in Elder Abuse referrals and 2,400 hours of care

in Senior Bed Crisis Program 35,573 Diagnostic examinations (ECG; X-Ray; Bone Density;

OBSP; Mammo; Ultrasound, Echo and CT) 1,817 Telehealth Clinic visits (double from last year) 108 referrals to Speech & Language program 409 employees at RVH (excluding physicians) 85 employees are eligible to retire 85 Job Postings 51 New Hires CUPE Pay Equity reviewed 20 positions

Annual Celebration of Worklife Dinner honored 71 employees and physicians

Exit Interviews policy developed and launched in April 2013 Workplace Wellness Stats:

o Christmas auction for Child Poverty Action Network raised $4,712 ($4,319 in 2011/2012)

o 35+ various Education Sessions provided for staff o Smoking Cessation Program continued o Employee Assistance Program launched and 8 employees accessed

services in the first quarter Database tracking employee mandatory training launched in January 2013 Regional Assault Care Program (RACP) had 2 abstracts accepted for

presentation at International Association of Forensic Nurses RVH’s RACP is the first of 35 Sexual Assault/Domestic Violence

Treatment Care Centers in Ontario to expand it’s services to include Elder Abuse

Planned and implemented a Falls Assessment decision tree and completed mock falls for staff training

On Complex Continuing Care Unit, with shift of patients from “chronic” to “active”, more attention was focused on changing the learning needs for staff (i.e. Acquired Brain injury education; dealing with disruptive/challenging behaviors)

“Home First” philosophy is supported and explored with all discharges and placements from Complex Continuing Care

Continued with selection, purchase and implementation of new Pharmacy software in order to facilitate upcoming unit dose automation and automated dispensing cabinets

Supported 16 Professional staff to attend Canadian Association of Nephrology Nursing National Conference in Ottawa in October 2012